Tuesday, February 22, 2011

I'm a LITTLE Pissed....how fat bias has affected me!

Yea, I'm a "big" girl.  I always have been.  I remember being taller (and probably bigger) than EVERYONE in kindergarten.  That is my first memory of my size.  My mom tells me my pediatrician told her to put me on a diet when I was two.  I would've fired him then and there...but I was only two.  When I was 12, in 6th grade, I remember being weighed.  I remember, exactly, weighing in at 135 lbs.  I don't remember my height, but I couldn't have been a whole lot shorter than I am now (5'6").  But, I remember being considered "overweight."  Two memories, years apart, and my issues with fat start.

The ONLY thin people in my family are the athletes.  There are quite a few athletic people in my family.  But, God decided not to even out the talent, and just gave a few of them a lot of ability!  My brother and a few cousins played sports at the college level.  Not me, and not really most of us.  The rest of us, well, we're pleasantly plump.

But (and isn't there always a but?), I AM healthy.  I've always had a healthy blood pressure (except those last few weeks of my first pregnancy).  I've never had high cholesterol.  Nothing at all.  So, my health insurance at work was offering a health screening.  You get weighed.  You get your blood pressure taken.  You get some labs drawn (a lipid profile, nicotine, cotine, & blood sugar).  No big deal...right?  Well, I got the results back today.  And, as expected ALL of my lab results were considered normal.

But wait....aren't ALL fat people unhealthy?  Shouldn't my blood pressure be high?  Shouldn't my LDL be through the roof?  And surely my fasting blood sugar should indicate I have diabetes, right?  Well, they don't.  Of course they don't.  I am healthy.  But, I'm fat.

So, I have to have a physician (yep, it specifically says physician) referral before I get any of the (monetary) benefits of having this health screening.  Why?  I'm fat.  I'm also 31 weeks pregnant & WILL not participate in ANY weight loss program until my child is on the outside!  Also, I refuse to take part of any aggressive weight loss while I am breast feeding.  (Which is likely to be a long time!)

My other issue is with the fact it's a "Physician Referral Notice."  It even says "M.D." signature.  As a nurse practitioner student and a patient of a Certified Nurse Midwife, I should be able to have any qualified health professional look at this & set REASONABLE goals with me.  I should be able to see an NP, a CNM, a PA, or even a DO, if I want.

And, this isn't the first time I've been affected by fat bias.  I was declined for health insurance (which we ultimately declined them, so I'm not even sure if that counts) because of my weight.  That was the first time I really felt fat bias.  I was hurt.  I was devastated.  It meant I had to work part-time while attending school full-time, just to have health insurance.  I've done it.  And I've utilized less health care than anyone in my family during the past year.

Why is all this bias coming from insurance companies?  Well, I just think they don't care about people.  They care about the all-mighty dollar.  Everything is black and white to insurance companies.  Wow, her BMI is high.  I bet she's gonna have a stroke any day.  If she doesn't have a stroke, surely she'll have diabetes.  And, I bet she doesn't eat healthy.  And definitely doesn't exercise.  Nope, not the fat ones.  They eat junk food & watch TV all day, every day.

While I was griping about this to my husband, he laughs, and brings up a friend of ours who by any insurance standards would be considered "obese."  He's a police officer in a very large metropolitan city.  He's also a body builder.  He is probably 5'10" and weighs probably 220 pounds.  I calculated a BMI based on those measurements.  It's 31.6.  So, maybe he could get health insurance....if he cut is leg off.  In all reality, this nameless police officer probably has a waist circumference of 30" (my guess) and probably has less than 5% body fat.  Now, I'm not saying he is HEALTHY, because I think that's just gross.  And he is doing weird things to his body (we are NOT supposed to look like that!).  But, he is NOT fat.  Not in any way shape or form.  But, if you look at his BMI, he's obese.  Really? Come on!

So, my thoughts.....THE BMI SUCKS!!!!

It's a horrible indicator of health.  It tells you nothing, except how a ratio of height to weight.  It does not take into account muscle mass, body type, or health.  Nothing.  I hate it.  I know skinny people who are more unhealthy than I am.

When I'm in practice, I refuse to use the BMI as a health indicator.  There's my promise to all of you.  Come see me (in about a year and half) and I will not calculate your BMI.  I may not even weigh you.

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